Can Your Genes Predict Response to MDMA Therapy? with Dr. Dave Rabin MD, PhD

In this episode, Erica Zelfand, ND joins to discuss the important topic of pill shaming in psychedelic communities and how psychedelic medicine and traditional pharmaceuticals can both support healing. Dr. Erica Zelfand specializes in integrative mental health, bridging the gaps between conventional and alternative medicine. In addition to seeing patients in private practice, she also teaches facilitation internationally and leads retreats through Right to Heal. In this conversation, Dr. Zelfand tackles the issue of pill shaming in psychedelic communities, showing why this rhetoric falls short and ultimately harms patients. She discusses complementary roles for psychedelic and traditional pharmaceutical medicines, suggesting that a medicine like ketamine may be particularly effective in contexts of acute intervention, whereas an SSRI antidepressant may be most effective for maintenance. Dr. Zelfand notes, however, that drug-drug interactions can be a significant concern and stresses the need for medical expertise and supervision in the context of concomitant usage of pharmaceuticals and psychedelics. In closing, she emphasizes that what is ultimately important is that patients are able to progress in healing, and any tools that are able to safely and effectively support this goal have an important role to play and should not be denigrated.    In this episode you'll hear: The pill shaming rhetoric in psychedelic and cannabis communities Pharmaceutical contraindications to psychedelic therapy and the necessity of medical supervision for tapering off such medications Why comparing traditional antidepressant pharmaceuticals to psychedelic medicines is often an apples to oranges comparison The issues with “no pain, no gain” rhetoric in healing Psychiatric support for processing repressed memories uncovered during psychedelic journeys   Quotes: “When I went into medicine, I actually specifically went into integrative medicine, functional medicine, because I didn’t like that patients were being in this position of having to choose: the conventional route or the alternative medicine route. Both routes have their merits and both routes have their shortcomings and I felt like we all deserve to be able to access both and have it be an integrated model.” [3:06] “The only form of ketamine that is FDA approved for depression—which is Spravato—is only approved in the context in which the person is also taking an oral antidepressant.” [20:48] “We have data showing that if you feel really really freaked out and anxious during your [psychedelic] trip, your outcomes aren’t necessarily as good. And the biggest predictor of having a positive experience is actually feeling awe. You don’t have to do the ego death thing, but if you can feel awe, if you can feel inspiration during a trip, your outcomes are better. And there’s even data showing that individuals who are on an SSRI and then trip—they may actually have better outcomes than people who don’t take medication.” [24:12] “I think part of this trepidation is we don’t want to harm anybody through a dangerous, or potentially lethal, drug-drug interaction. That’s one thing. It’s another thing to be like ‘yeah but if you’re using these [pharmaceutical] drugs you’re doing it wrong and you’re not healing right.’ And I think the one often is used as a camouflage for the other—and they’re two separate things.” [38:59]   Links: Dr. Zelfan’s website Dr. Zelfand on Instagram Dr. Zelfand on Twitter Dr. Zelfan on LinkedIn Right to Heal website Psychedelic pill-shaming article by Jules Evans and Shayam Suseelan Previous episode: Integrating Challenging Psychedelic Experiences with Keith Kurlander, MA Previous episode: Warning Signs When Selecting a Psychedelic Facilitator with Juliana Mulligan Previous episode: How to Choose a Psychedelic Facilitator or Retreat Center with Joël Brierre Psychedelic Medicine Association Porangui  

In this episode of the Psychedelic Medicine Podcast, Keith Kurlander, MA, LPC, joins to discuss the important topic of integration practices for challenging psychedelic experiences. Keith is the Co-Founder of the Integrative Psychiatry Institute, the largest professional education company specializing in integrative mental health and psychedelic therapy. In this conversation, Keith begins by exploring the different types of challenging psychedelic experiences and various lingering effects one may experience following a difficult psychedelic journey. He discusses these from a trauma-informed perspective, explaining how a traumatized nervous system can lead to dissociation on the other side of an intense ego-disrupting experience. Keith also shares practices and insights from internal family systems (IFS) for integrating challenging psychedelic experiences. In closing, he emphasizes that psychedelics are not lazer-targeted therapies, so they do carry inherent risks, but through effective integration practices, patients can make healthy meaning out of even negative experiences.    In this episode you'll hear: Lingering issues with ego fragmentation and connections to the dissociative disorder spectrum Persisting psychotic disorders following psychedelic experiences The difference between CPTSD and PTSD Uncovering repressed traumatic memories during psychedelic journeys Trauma stemming from difficult psychedelic experiences  Challenging spiritual experiences   Quotes: “The concept of pendulation [is] that we can be more flexible to ease our way into these overwhelming states. So once we are totally overwhelmed, we have to work our way back out gracefully, but as we are doing that, you get a gem as you are coming back… you learn something as you are coming out of that state.” [18:02] “If people have a psychotic disorder that emerged after their psychedelic use, you need a psychiatrist at that point… If it’s really a psychotic emergence, whether a previous psychotic disorder got triggered or whatever, you need a psychiatrist to work with you on that.” [20:07] “I believe all these mental health conditions have a trauma process underneath them. I don’t know how you isolate a trauma process from a mental health condition” [25:30] “It’s about working with a person’s meaning-making structure: is the meaning they’re making creating more psychological flexibility or less psychological flexibility? That’s a really important question to hold as a therapist because people will make all kinds of meaning up from these experiences but if they’re creating meaning that’s creating more rigid structures of how they see the world, then they get disappointed more often.” [34:21]   Links: Psychiatry Institute website Keith’s website Keith on Instagram Higher Practice podcast  Previous episode: The Challenging Psychedelic Experiences Project with Jules Evans Psychedelic Medicine Association Porangui  

In this episode of the Psychedelic Medicine Podcast, East Forest joins to discuss several aspects at the intersection of music and psychedelics, including how he created the music that so many have used when facilitating psychedelic journeys. East Forest’s latest project, a feature length documentary film called Music For Mushrooms, follows him through the psychedelic renaissance on a mission to pair music with psychedelics to bring about transformative healing to a world in crisis. In this conversation, East Forest discusses how he first got started making music for psychedelic journeys and the considerations that go into curating the right sound to best support these types of deep inner experiences. He emphasizes the importance of avoiding music that sounds overly sentimental and lacks the depth and richness important for effective psychedelic exploration. He also discusses the importance of maintaining the container, whether in the context of psychedelic facilitation or purely music-focused ceremonies, and suggested that sternness and fortitude have an important function in this context. In closing, East Forest suggests that music is so powerful because of the way it is able to be a point of connection to integrate experiences and bring people together.   In this episode you'll hear: Composing soundtracks for psychedelic journeys with different substances Integrating nature sounds into compositions Flow states and music Bringing live elements of music and sound into a psychedelic ceremony Singing as a regulating technique during a psychedelic journey The intersection of music, technology, and psychedelics   Quotes: “If we look at psychedelic experiences and ceremonies from indigenous use, all of them that I know of were guided by music.” [3:16] “I think it’s more the intention behind the music. I don’t think there’s a particular thing you have to do or not do, but I don’t think you can just play any music. So I think it’s the intention of the music and the intention of the room and the intention of the participants… There has to be an invitation on all of those fronts for that doorway to open.” [16:11] “I think we’re looking for music and for space that is supportive of that through-line and gives us enough time to be in a process—and that’s another advantage of having these longform, intentional, bespoke songs because they are probably going to give more of that time and space for these processes to occur.” [32:43]   Links: East Forest’s website East Forest on Instagram East Forest on Tik Tok Music for Mushrooms documentary website Music for Mushrooms Official Documentary Soundtrack Winter Solstice Retreat at Esalen Music for Psychedelic Therapy by Jon Hopkins Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Eric Sienknecht, PsyD joins to discuss the roles of music in psychedelic sessions. Dr. Sienknecht is a licensed clinical psychologist and co-founder and lead trainer at Polaris Insight Center, a ketamine-assisted psychotherapy clinic and training center. He has worked as sub-investigator and study therapist on the Lykos-sponsored MDMA-AT clinical trials for PTSD and currently is also a supervisor and educator in MDMA-AT for various clinical trial sites. Dr. Sienknecht has a deep interest in the role and use of music in ketamine and MDMA sessions and specializes in curating playlists for psychedelic experiences. In this conversation, Dr. Sienknecht discusses how he first realized the importance of music in psychedelic experiences. He shares insights on how different genres and moods of music may be better suited to certain phases of the psychedelic experience and how he works individually with clients to better tailor a session playlist to their personal taste. Dr. Sienknecht even discusses how to strategically include shadow elements in a playlist to facilitate a client going deeper in their journey. In closing, he emphasizes how the intersection of psychedelic experiences and music remains understudied with only a few book chapters and articles dealing directly with the topic, so there is much yet to learn and explore in this exciting niche.    In this episode you'll hear: What is universal vs what is individual when it comes to music and psychedelics Why Dr. Sienknecht avoids music with lyrics in a participant’s native language for psychedelic sessions The research on different genres of music for psychedelic journeys Balancing planning music in advance and adapting to the specific pace and mood of the client’s experience Utilizing nature sounds alongside or within music during psychedelic sessions Binaural beats and brainwaves   Quotes: “There’s generally better tracks to use for the opening phase of a [psychedelic] journey, for the peak phase of a journey [etc], and there’s been some research into that as well.” [6:05] “Taste is so subjective… Knowing your client and talking with them beforehand about their taste and letting that information really inform how you create the playlist is really important.” [27:02] “One of the benefits of doing psychedelic therapy is that you can surrender control over elements of set and setting—not that those aren’t negotiable and ongoingly negotiable, as they should be—but there’s something about [the fact that the therapist] has got the music taken care of, the room set up, everything is in its right place. All I have to do is fast from food for a few hours, have my intention, and step into the journey—and that can help someone to really just trust and surrender more into the experience.” [30:20]   Links: Integral Psychedelic Therapy edited by Jason A. Butler, Genesee Herzberg, and Richard Louis Miller Dr. Sienknecht on LinkedIn Polaris Insight Center on LinkedIn Polaris Insight Center website Music for Ketamine-Assisted Psychotherapy Sessions training with Dr. Sienknecht at Polaris Insight Center Previous episodes: Psychedelics and Nature: The Symbiotic Relationship with Dr. Sam Gandy Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Giorgia Caspani, PhD joins to discuss the intersection of psychedelics and the gut microbiome and ramifications for future personalized medicine. Dr. Caspani is a neuroscientist and computational biologist working at the intersection of gut microbiome, psychedelics and personalized medicine. In this conversation, Dr. Caspani discusses her research published in the article “Mind over matter: the microbial mindscapes of psychedelics and the gut-brain axis.” She shares what we know about how psychedelics impact the gut microbiome from initial studies and what questions remain unanswered. She draws connections between the way the gut microbiome metabolizes SSRI drugs and how serotonin impacts the gut microbiota to hypothesize the potential ways psychedelics interact with this complex living system. In closing, Dr. Caspani discusses the possibility of predicting responses to psychedelic treatments using data from the microbiota, and the research currently happening to make this possible.    In this episode you'll hear: How human beings and our gut microbiome co-evolved and the benefits achieved through this symbiotic relationship The correlation between the gut microbiome and stress levels  The effects of psychedelics on immune responses Why personalized medicine may be a more effective approach for treating depression How personalized medicine could help make psychedelic therapies more accessible and effective   Quotes: “Without our gut microbes… We wouldn't be able to really perform a lot of the metabolic functions that we rely on as humans.” [4:26] “The gut microbiome is different in every person—it’s very unique. And so every person carries this unique microbial signature that can potentially map out to all of the treatment options that we already have available; it’s just a matter of understanding and identifying markers that can predict which patient will benefit from a specific drug.” [18:22] “[We hypothesize that] the gut microbiome shapes individual responses to psychedelic treatment. And so if that [hypothesis] is correct, if that is true, we could potentially target the microbiome, change the composition of the gut microbiome like we wanted to, to be able to maximize the effectiveness of these [psychedelic] drugs.” [25:14] Links: Dr. Caspani’s article, “Mind over matter: the microbial mindscapes of psychedelics and the gut-brain axis” Dr. Caspani on LinkedIn Dr. Caspani on X Onaya Science website Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Star Rose Bond, LCSW joins to discuss the topic of using psychedelic-assisted therapy to address intergenerational trauma. As seen in Huffpost, Vice and Psychology Today, Star Rose is a Renegade Psychotherapist, Social Activist, Clinical Supervisor for PEARL Institute and Co-Founder of Life Camp. With a Bachelor’s degree from NYU and a master’s from Columbia, Star brings 15 years of clinical trauma therapeutic services and experience serving marginalized, under-resourced and at risk populations specializing in harm reduction and PTSD recovery. In this conversation, Star introduces the topic of intergenerational trauma and explores how psychedelic experiences may be leveraged to address this pernicious condition. She begins by explaining what intergenerational trauma means, how it gets passed down, and how it manifests. Star talks about the importance of psychedelic therapists and facilitators having awareness of trauma-informed modalities in order to better serve these populations. She also discusses the complexities of addressing generational trauma, and how it can often be difficult to process sensitive topics within the family unit. However, in conclusion, Star emphasizes that the capacity to heal is an intrinsic aspect of human existence, and that even in particularly dark moments, it is possible to get in touch with this possibility.    In this episode you'll hear: How the conditions of Capitalism produce and exacerbate chronic stress The profound impact of neglect and abuse in early childhood  The unique experience of intergenerational trauma for BIPOC peoples and the recent rekindling of a spirit of connection in these communities due to psychedelic medicines  How processing intergenerational trauma can transform familial relationships Ethical and practical considerations for facilitators and therapists guiding clients through psychedelic experiences aimed at resolving deep-seated trauma What to look for in a psychedelic-assisted therapist or facilitator   Quotes: “Just because you have several students or several clients who’ve experienced the same trauma, don’t make the assumption that they’re all experiencing it the same way. Or maybe you’ll meet a client who has had trauma similar to yours—don’t assume that they have undergone the same emotional impact or psychological impact as you. The truth of the matter is we are complex beings. We have so many different moving variables that go into our psychology and that essentially indicate or play a role in how we respond to things.” [8:43] “We can’t always express or understand why things happen the way they do. But, we can start to make meaning through a spiritual understanding which in turn lends itself to a sense of ease and comfort.” [22:20] “When you are going into these experiences as a facilitator—whatever your background is—it is of the utmost importance that you are hyper cognizant and hyper aware of the harms that can be caused by not being aware of the ways in which you can navigate someone else’s trauma as it shows up.”  [25:02]   Links: Star’s website Star on Instagram Previous episode: Can Your Genes Predict Response to MDMA Therapy? with Dr. Dave Rabin MD, PhD Previous episode: Warning Signs When Selecting a Psychedelic Facilitator with Juliana Mulligan Previous episode: How to Choose a Psychedelic Facilitator or Retreat Center with Joël Brierre My Grandmother's Hands: Racialized Trauma and the Pathway to Mending Our Hearts and Bodies by Resmaa Menakem SHINE Support website Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, L.J. Lumpkin III, MA LMFT joins to discuss the potential of psychedelic medicine in the context of sports psychology. L.J. is a therapist, adjunct professor at Pepperdine University, a coach, author, speaker, and the CEO of Nomad Healing Practices. In this conversation, L.J. shares his personal experience as an athlete and discusses the difficult transition to a new life once an athlete’s career has concluded. He compares the need to reinvent oneself in this context to ego death and explains how psychedelic-assisted therapy may be helpful for navigating this transition. L.J. also discusses the intense pressure athletes are under to perform, mentioning that the drive to win can often overpower the more basic mode of play at the heart of athleticism. This is an area where he finds ketamine to be a particularly powerful medicine, as its dissociate quality can help athletes tune out the high pressure expectations. L.J. also discusses leveraging the critical learning period provided by psychedelic therapies to institute new healthy habits, something which could benefit athletes both on and off the field.    In this episode you'll hear: How ketamine-assisted therapy may be able to help athletes with their unique psychological challenges Integrating mindfulness to prepare for psychedelic therapies Leveraging the somatic component of psychedelic therapies to address pain The importance of integration practices and support systems The differences between working with psilocybin versus ketamine Drowning out critics and sports commentary and getting back to basics with the help of psychedelic therapy   Quotes: “If you’ve been paid millions of dollars to hit and be aggressive for so long and that’s how you’ve dealt with your emotions—and it wasn’t a problem because you were being rewarded for it—what do you do when you’re not getting rewarded for that anymore? When you have to actually change how you process emotion—there’s not a playbook for that.” [7:46] “Just talking about [mental health] and normalizing it—all of a sudden you’re allowed to get help, you’re allowed to heal, you’re allowed to go to practices that have been practiced throughout human civilization. We’re bringing [psychedelics] back and I think that athletes are the ones who are really going to be the ship of normalization.” [22:38] “Especially if you’re off season, those other medicines [besides ketamine] I think they’re going to be even more helpful because that might encourage the rest, it might encourage being able to connect with family systems. I think for some of the more acute stuff, the ketamine does serve a great purpose in that.” [28:16]   Links: L.J. on Instagram L.J. on LinkedIn Nomad Healing Practices website  Psychedelic Medicine Association Porangui  

In this episode of the Psychedelic Medicine Podcast, podcast host Dr. Lynn Marie Morski comes on the mic to provide a five-year update on the podcast and share the changes in the legal landscape of psychedelics in the past half-decade. Lynn Marie Morski, MD, JD is the president of the Psychedelic Medicine Association and host of the Psychedelic Medicine Podcast. She sits on the advisory boards of Psychedelics Today, Cybin, VETS, Inc (Veterans Exploring Treatment Solutions), the Oxenberg Foundation, and the Ketamine Task Force. Dr. Morski is a Mayo Clinic-trained physician in family medicine and sports medicine, as well as an attorney and former adjunct law professor. In this anniversary episode you’ll hear about the legally-accessible forms of psychedelic therapy which have come to prominence as potential mainstream therapeutics in recent years. Dr. Mroski shares Information on the legal adult use framework for psilocybin in Oregon, including licensing, costs, and exclusion criteria. She also discusses programs in Australia and Canada that will allow certain patients to access psychedelic therapies such as psilocybin- and MDMA-assisted therapy. In addition to classic psychedelic medicines, Dr. Morski also shares information on the medicine which is currently most accessible: ketamine. She discusses the difference between S-ketamine and R-ketamine and on-label and off-label uses of this substance. In closing, Dr. Morski presents some of the finer details of the current landscape of insurance coverage for ketamine.    In this episode you'll hear: The difference between decriminalization and legalization The FDA decision to deny the Lykos Therapeutics’ new drug application for MDMA-assisted therapy for PTSD The upcoming Colorado psilocybin program Psychiatric licenses to administer MDMA and LSD to patients in Australia  The Special Access Program for psychedelic therapies in Canada  Legal ketamine access in the United States How the Psychedelic Medicine Podcast chooses guests   Quotes: “I wanted to focus mostly on what is legal because we know that’s the way things are going to be the most monitored and therefore safely accessible.” [20:45] “People are in this industry because they want other people to feel better and they want to help and they’re so generous with their time” [25:31]   Links: clinicaltrials.gov - the place to find information on upcoming clinical trials for psychedelic medicine for which you may qualify Insurance Coverage for Psychedelic Therapy by Vincent Joralemon SPRAVATO withMe Patient Support Program Enthea insurance Previous episode: How to Choose A Psychedelic Facilitator or Retreat Center with Joël Brierre Previous episode: Warning Signs When Selecting a Psychedelic Facilitator with Juliana Mulligan Previous episode: Ketamine Scientific Research with Dr. Jason Wallach Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Dr. David Rabin, MD, PhD joins to discuss whether genes can be predictive of one’s response to MDMA Therapy. Dr. Rabin, a board-certified psychiatrist and neuroscientist, is the co-founder & chief medical officer at Apollo Neuroscience. In addition to his clinical psychiatry practice, Dr. Rabin is also the co-founder & executive director of The Board of Medicine, and a psychedelic clinical researcher currently evaluating the mechanism of psychedelic-assisted psychotherapy in treatment-resistant mental illnesses. In this conversation, Dr. Rabin shares his research into epigenetic responses to MDMA-therapy, exploring topics of trauma, gene expression, and personalized, data-driven medicine. He discusses the seminal discovery that trauma can cause epigenetic changes in the structure and function of the cortical system and his own research findings that uncovered a reversal of these changes associated with MDMA-assisted therapy. Dr. Rabin hopes further research in this area may allow for leveraging epigenetic data to determine which psychedelic medicine a particular patient may be most likely to respond to and track how effective a given treatment has been. In closing, he expresses excitement about bringing objective biological precision to mental health treatment, drawing a parallel to the discovery of antibiotics which allowed for much more tailored treatments of infections which has saved countless lives.    In this episode you'll hear: Response rates to psychedelic-assisted therapy for PTSD versus conventional therapies The consequences of ineffective treatment for PTSD MDMA-assisted therapy as preventative care and the societal cost savings involved Genetics, epigenetics, and gene expression Using epigenetic data from simple saliva swabs to better gauge response to MDMA-assisted therapy for PTSD   Quotes: “Most of the treatments we have available today for PTSD—that are the FDA-cleared, considered gold standard treatments—only actually induce remission from illness… in about 30% of people. So of the 100% of the millions of people every year that are getting treated for PTSD, with the best treatments that we have that are currently available, only 30%—at best—are getting better long term. Everyone else has a diagnosis of PTSD for life.”  [3:55] “MDMA-assisted therapy for people with PTSD is having an effect that’s similar to what we saw with the discovery of antibiotics for infection.” [8:07] “Folks with severe PTSD who went through this trial, when they received MDMA-assisted therapy, [the researchers] saw a statistically significant change—in terms of repair—of the cortisol receptor’s epigenetic code which reflects improved structure and function of that receptor site. But not only that—we saw that the amount that people got better… was directly correlated with… the amount of remodeling and repair at the receptor site.” [18:36] “Epigenetic code is actually something that can be modified by experiences in our environment. And trauma—or PTSD diagnoses, a series of significant traumas over time—can in fact change epigenetic code of the cortisol receptor gene. And that changes how the cortisol receptor gene gets made, and it changes its function.”  [29:52] “PTSD is a disorder of learned fear. How do we treat PTSD? In animals and humans, we provide the same stimulation that they were getting that they are now afraid of in the context of safety. That’s how exposure therapy works, that’s how MDMA therapy works to some extent—all of these tools and techniques work to treat PTSD effectively… in the same way. It’s called safety conditioning.” [36:48]   Links: Dr. Rabin’s article: Pilot study suggests DNA methylation of the glucocorticoid receptor gene (NR3C1) is associated with MDMA-assisted therapy treatment response for severe PTSD Dr. Rabin’s website Dr. Rabin on LinkedIn Dr. Rabin on Instagram  Dr. Rabin on Twitter  Apollo Neuroscience website  Psychedelic Medicine Association Porangui

In this episode of the Psychedelic Medicine Podcast, Mark Braunstein, DO joins to discuss the promise and the peril of ketamine. Dr. Braunstein graduated medical school in 1997 then completed a General Psychiatry Residency at the University of New Mexico and then a fellowship in Child and Adolescent psychiatry at Maine Medical Center in 2002. Upon graduation from his fellowship and becoming board certified in general psychiatry he established a private practice in Durango, Colorado where plant medicine became part of his everyday integrative psychiatric practice.  In this conversation, Dr. Braunstein shares some of the developments in the world of ketamine in the past three years since his previous episode, drawing on his own experience providing ketamine-assisted therapies. He stresses issues of grandiosity that can arise both when working with ketamine and when taking the medicine—issues which in the worst case and fuel ketamine use disorders. Dr. Braunstein stresses the importance of clinicians providing ketamine treatments being realistic and upfront about the potential harms of ketamine when advising prospective patients. In closing, he warns against the dangers of being in an echo chamber which reinforces potentially pathological substance use, especially for clinicians in the ketamine space.    In this episode you'll hear: Why ketamine has an addictive potential and how ketamine addiction presents Ways to treat ketamine use disorder  The importance of informed consent What patients should look for when seeking a ketamine provider The importance of ketamine providers working with multiple modalities and having multiple tools in the toolbox besides ketamine    Quotes: “Here’s what’s scary to me about ketamine: these people that I’ve seen having problems [with ketamine use] are largely lifetime recreational psychedelic/drug users without problems. And these are people who have made it to age fifty, smoking [cannabis], tripping a little bit, their whole life without having a problem—then at fifty years old, find themselves hooked on something for the first time.” [12:30] “[Ketamine] is not a microdosing medication… There is no such thing as ketamine microdosing. You think of microdosing as sub-perceptual. Everyone that I’ve met that’s abusing ketamine, it was not a sub-perceptual effect—they were very much abusing it to have that perceived effect. Maybe not a psychedelic effect—usually an intoxicated wonky effect is what they’re going for. And people refer to that as microdosing. It’s not microdosing. It’s abusing small doses.” [17:11] “What do I see that makes me concerned with someone I’m talking to—a clinician or a client? That grandiosity. So that gets me concerned right away when I hear about these ‘downloads’ because that’s where … other psychedelics can have dependency too. You see people … they go for aya ceremonies every week after week after week. So there can be an addiction to the download or to the release.” [34:35] “The people I know that have been successful in this line of work (from a patient standpoint), whether they’re a clinician or not, have been the ones that have embraced the work. And just knowing that this is going to be a process and I’m in it to win it, for life. I’m working on myself.”  [35:40]   Links: Dr. Braunstein on LinkedIn Ketamine Research Foundation website NeuPath Mind Wellness website  Ketamine Training Center website Previous episode: Ketamine for Alcohol Use Disorder with Steven Mandel, MD Previous episode: Avoiding the Traps of Psychedelic Self-Absorption with Adam Aronovich, PhD(c) Previous episode: Navigating Psychedelic Narcissism with Adam Aronovich Previous episode: Psychedelic Therapy: Slow Down to Heal Faster with Sunny Strasburg, LMFT  Psychedelic Medicine Association Porangui